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A 32-year-old worman, gravida 2, para 1, at 40 weeks' gestation is brought to the emergency department by her husband because she has been confused for 45 minnutes. Her husband says that she has been in labor for 3 days at home, and she has recieved all her prenatal care from an alternative provider. This morning the caregiver gave the patient a natural product to chew to induce contractions. She began to have strong, regular,, painful contractions, and after 6 hours, she suddenly lost conciousness. On arrival, she is obtuned. her pulse is 140/min, and palabalbe systolic blood pressure is 60 mm Hg. Abdominal examination shows distention and rigidity and a 25-cm, irregular mobile mass in the upper right quadrant. The cervic is 3 cm dilated and 50% effacted; no presenting fetal part can be palpated. which of the following is most likely cause of thse findings?

A) Coagulopathy
B) endomyometritis
C) methamphetamine use
D) uterine atony
E) uterine Rupture

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